Cardioplegia for severe coronary artery disease: an improved technique using direct coronary artery infusion.

Conventional techniques of cardioplegic solution administration result in regional disparities in the level of myocardial protection in patients with severe coronary artery disease. This report describes a simple adjunct to conventional transaortic administration of cardioplegic solution, in which additional solution is introduced directly through the coronary arteriotomy used for the vein graft anastomosis. The supplemental infusate is delivered through s small-caliber flexible catheter. This technique permits effective perfusion of the coronary vascular bed distal to severely stenotic and occlusive lesions. Using an experimental model of physiologically significant coronary arterial stenosis, we compared the effectiveness of this technique with that of conventional techniques of cardioplegia.